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cannabinoids in different diseases and case reports on the use of cannabis by
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|Title||The effect of orally and rectally administered delta-9-tetrahydrocannabinol on spasticity: a pilot study with 2 patients.|
|Author(s)||Brenneisen R, Egli A, Elsohly MA, Henn V, Spiess Y|
|Journal, Volume, Issue||International Journal of Clinical Pharmacology and Therapeutics 1996;34(10):446-552|
|Major outcome(s)||improvement of joint function and ability to walk; in 1 patient additional alleviation of pain|
|Indication||Multiple sclerosis; Spinal cord injury; Spasticity; Pain||Abstract|
Multiple doses of delta 9-tetrahydrocannabinol (THC) capsules (Marinol) and THC hemisuccinate suppositories were administered in 24- hour intervals to 2 patients with organically caused spasticity. After oral doses of 10-15 mg THC, peak plasma levels from 2.1 to 16.9 ng/ml THC and 74.5 to 244.0 ng/ml 11-nor-9-carboxy-delta 9- tetrahydrocannabinol (THC-COOH, major THC metabolite) were measured by GC/MS within 1-8 h and 2-8 h, respectively. After rectal doses of 2.5-5 mg THC, peak plasma levels from 1.1 to 4.1 ng/ml THC and 6.1 to 42.0 ng/ml THC-COOH were measured within 2-8 h and 1-8 h, respectively. The bioavailability resulting from the oral formulation was 45-53% relative to the rectal route of administration, due to a lower absorption and higher first-pass metabolism. The effect of THC on spasticity, rigidity, and pain was estimated by objective neurological tests (Ashworth scale, walking ability) and patient self- rating protocols. Oral and rectal THC reduced at a progressive stage of illness the spasticity, rigidity, and pain, resulting in improved active and passive mobility. The relative effectiveness of the oral vs. the rectal formulation was 25-50%. Physiological and psychological parameters were used to monitor psychotropic and somatic side-effects of THC. No differences in the concentration ability, mood, and function of the cardiovascular system could be observed after administration of THC.
|Dose(s)||10-15 mg oral; 2,5-5 mg rectal|
|Type of publication|
|Address of author(s)||Institute of Pharmacy, University of Bern, Switzerland|